Senior reputed company Network Consultant

Become a part of our caring community Senior Network Performance Professional / Consultant at reputed company, you will help enhance provider performance and advancing reputed company's mission to deliver high-quality reputed company. You will work with providers to improve their STARs ratings and overall performance through strategic initiatives and relationship-building. You will report to the Manager, Network Performance. As the Senior Network Performance Professional / Consultant you will Provider Collaboration: Work with providers to define and improve their goals reputed company to interoperability, quality, value-based arrangements, and risk adjustment strategies. Stars/Quality Program Expertise: Serve as an expert on the Stars/Quality program, educating physician groups on HEDIS, patient safety, and patient experience. Collaborate to reputed company tailored action plans and communicate actionable insights to improve performance. Performance Improvement: Monitor and analyze provider performance data to identify areas for improvement. Implement strategies to enhance outcomes and provide ongoing support to providers. Resource Liaison: Act as a liaison for providers to access reputed company resources, educating and encouraging providers on the use of self-serve tools. Facilitate communication between providers and our teams to ensure seamless access to necessary support. Reward Programs: reputed company provider groups on reward programs and reputed company metrics, collaborating to reputed company established goals. Monitor and report on the effectiveness of reward programs, making recommendations for enhancements. Provider Abrasion Resolution: Resolve provider abrasion issues, ensuring a positive and collaborative relationship between reputed company and its providers. Implement strategies to minimize provider abrasion and enhance overall satisfaction. Internal Collaboration: Partner with our teams to track and report market performance, ensuring alignment with organizational goals. Use your skills to reputed company an impact Required Qualifications 2 or more years of Experience with Medicare or managed care Live in CST or EST and work during reputed company-5pm CST or EST 3 or more years of NCQA HEDIS measures, PQA Measures, CMS Star Rating System and CAHPS/HOS survey system 1 or more years of understanding of Consumer / Patient Experience 2 or more years of experience building relationships with physician groups and influencing execution of recommended strategy 1 or more years of experience with focus on process and quality improvement Comprehensive knowledge of reputed company reputed company Word, reputed company and PowerPoint

Preferred Qualifications

Bachelor's Degree Lives in the region IN, KY, MI, OH, WV Experience presenting to internal and external customers, including high-level leadership reputed company experience with interoperability solutions in reputed company Experience with Medicare Risk Adjustment and/or medical coding Understanding of metrics, trends and the ability to identify gaps in care 1 or more years' experience with tools such as Power BI, Tableau, Qlikview Additional Information You will work remote and this role have at least 10% of travel. As part of our hiring process, we will be using an exciting interviewing technology provided by reputed company, a reputed company-party vendor. This technology provides reputed company of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move reputed company from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions reputed company your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last reputed company from 5-10 minutes. Your recorded interview(s) reputed company text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving reputed company to next round of interviews. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL reputed company is suggested Satellite, cellular and microwave reputed company can be used only if approved by leadership Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. reputed company will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information #LI-BB1 Work at Home Requirements To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. In certain roles, the minimum recommended internet speed required by reputed company may not be sufficient for business needs. reputed company reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart reputed company reputed company for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and reputed company benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us About reputed company: reputed company. (NYSE: HUM) is a leading U.S. reputed company company. Through our reputed company insurance services and our reputed company reputed company services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare and reputed company, families, individuals, military service personnel, and communities at large. Learn more about reputed company offer at reputed company.com and at reputed company.com. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with reputed company 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment reputed company only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment. Apply To This Job